Lotti Rutter & Leonora Mathe, Treatment Action Campaign
The hospital is full. Two young girls lie on trolleys in the main hallway. They are
wrapped in pink blankets; drips come out of their arms and hang on the walls. One looks in severe agony. She calls out for a nurse again and again. Their mother tells us that they arrived at the hospital seven hours ago and have yet to leave the hallway. Laughter comes from the nurses’ break room. It is situated directly opposite their trolleys, but no-one ever emerges to help.
An old man with only one leg sits next to them. His drip is attached to the same set of hooks. He stands in pain. He struggles with his crutches, his drip and his file in order to slowly move down the dusty passage to the toilet. The toilet will not flush, and is dirty after people have tried. A poster haphazardly taped to the wall in the bathroom informs patients that they should “always wash their hands”. Yet the soap dispenser is empty, and there are no taps to provide water. The floor is filthy.
Overcrowding, dirty facilities, bad services and poor attitudes. This is what awaits public healthcare users at Prince Mshiyeni Hospital in Umlazi, the largest township close to Durban.
Treatment Action Campaign branches monitor the state of health care at hundreds of clinics and hospitals across the country. They are the people who need the public healthcare system to work, so they are the first to notice when it does not. Prince Mshiyeni Hospital is not alone in its dysfunction. In recent weeks, a TAC fact-finding mission has showcased the crisis in several public hospitals.
We visited hospitals in KwaZulu-Natal, Limpopo, Mpumalanga and Gauteng. And the situation in each is as dire as it is in the next.
In Limpopo, at Malamulele Hospital, people begin queuing at the old and run-down facility from 5.30am. The corridors are full. At each turn, brightly dressed women fill the hallways. Around 200 people are waiting to be attended to by only two doctors. The waiting is unbearably long. We are told that there has been no constant water supply at the hospital for three years. Patients are unable to wash themselves, and there is only a small amount of container water available for using the toilets. As we walk through the wards during visiting hours, the patients have no privacy. There are no doors or curtains. The wards smell, and the bed linen is dirty.
In Tshilidzini Hospital, more than 75 patients wait for their files. Each time a shrill voice screams out a name, the chain of people patiently moves one seat across. People have been waiting in this queue for over five hours. A few people waiting are already wearing Tshilidzini hospital gowns. One is a young man with an open wound on the back of his neck – the wound and stitches are uncovered, and he uses a wad of toilet paper to stop it seeping. And the file room is only the beginning; once they leave, patients are faced with more long queues to be attended to by a doctor.
In Elim Hospital, patients wait for files for around five hours. After collecting their files, they enter the hospital and join a long queue to be seen by a doctor. In a corridor around 100 metres long, patients on back-to-back benches fill the entire space, waiting to be seen. Those with bad coughs sit with everyone else – in a corridor with windows on just one end. As we walk around, at each turn a new queue appears. More faces are raised in hope at the sight of us. In the main hallway, a man is sitting on a trolley, under a blanket. A drip comes out of his arm. He tells us he was admitted six hours ago, but nurses have yet to find a bed for him to be moved to.
In Mpumalanga, at KwaMhlanga Hospital, the corridors are full. One old gogo
(elderly lady) lies on a trolley in the corridor, in severe pain. She struggles to move, and has not yet been attended to. People in wheelchairs are stacked together, each man’s knees squashed into the chair in front of him. Hundreds of people wait to be seen. Their eyes follow us as we pass through the corridors. One man sits in casualty with a home-made sling on his arm. After being attacked by thugs, he had attempted to access services at the hospital. An X-ray had been taken the night before – yet only a day later, his file has been lost. He is told to go and submit an affidavit at the police station, and return. He has no money, and has received no painkillers. The young man sitting next to him has been waiting for five hours. A baseball cap covers a bloody stain on the back of his head.
In the most well-resourced province, Gauteng, the recently refurbished Thelle Mogoerane Hospital still suffers the same level of neglect as before. Casualty is overcrowded, and the queues last for hours. People sleep in the corridors. Patients bleeding and in critical condition sit with everyone else. A psychiatric patient is seen wandering around the wards. We are told that for days, patients have been fed porridge for every meal. One woman shows us an X-ray of her broken jaw. She had been sent home with just a Panado for the pain. Another woman told us that post-labour, the doctors had sewn her vagina shut – when she returned to question them, they told her she must have been born that way. Another woman explained how, during labour, doctors took another woman into her space in theatre. Eventually, after waiting the whole day to be seen, she gave birth to her baby. The baby was green, and died six days later.
Poor management, budgetary constraints and a lack of care for the needs of patients plague these public facilities. And it is the people who suffer. In order to expose these crises, and hear from the people who need to use these services, TAC will be holding public hearings and showcasing people’s stories in the run-up to World AIDS Day.
As we leave Prince Mshiyeni Hospital through the abandoned trolleys, a woman sits sobbing in a wheelchair. Under a blanket her feet are badly swollen, and she struggles to breathe. We can see the fear in her eyes. She has just been discharged. A nurse leaving the hospital passes by; we try to engage with her to re-admit the woman, but she informs us as she rushes away that she will let the security guard know he must look for the woman’s friend. After TAC intervenes, she is re-admitted. Upon being examined, she is diagnosed with pneumonia and cryptococcal meningitis. She is moved to a cold and overcrowded ICU ward, beds mere centimetres apart. She has not been allowed to keep her blanket, and is visibly shaking when we visit.
When we eventually leave the facility, the young girls cocooned in pink are still where we found them in the dirty corridor, hopeless, still waiting for help.
|A litany of atrocities at Prince Mshiyeni Hospital|
|- A wheelchair lies abandoned on the pavement, and trolleys are scattered across the casualty entrance of the hospital. Dirty rags line the floors as we enter. We are greeted by dust, dirt, and dirty chip packets.
- Family members push patients up and down the hall on trolleys. One patient looks in severe pain, lying on her side on a trolley; she rests her head on a water bottle that acts as a pillow.
- A diabetes patient waits to collect chronic medicines. Last month she waited through the day until 11pm, only to have to return the next day. Before speaking to us today, she has already waited for over eight hours.
- Paper files lie on the unattended counter for anyone to look at. One woman waited for eight hours until they located her file.
- At 4.30pm, more than 100 people still need to be seen. Every corridor of the hospital has more and more patients, sitting, waiting to be attended to.
- One small room has at least 25 beds haphazardly squashed into it. Another has only a few centimetres between each bed. It seems that psychiatric patients have been put next to other patients.
- A woman with her leg in a cast had come to the hospital in agony seven hours prior, in an ambulance. The previous month they had cast her leg without having taken an X-ray. At 4.30pm she is told the X-ray department has closed, and she should return the next day. The doctor has not seen her. As she leaves the hospital in a wheelchair, she is still in agony. In her opinion, coming to this hospital is a waste of time.
- Three people struggle to get an unconscious person – who has been discharged – into the back of a car. They use a piece of material to get the person off the trolley, and eventually, onto the back seat. During this 20-minute challenge, cleaners look on.
- An old man, looking gaunt and sick, leaves the hospital. A pulled-down TB mask rests on his neck.
- A hungry man eventually leaves the hospital by getting a lift with strangers. He has been there for eight hours. He has no money for food or for a taxi.
- A white van emblazoned with a “21st Century Funerals” logo stands outside the accident and emergency entrance. A trolley is carried out of the back and taken inside the hospital. A while later the driver returns, pushing a corpse in a body bag past patients entering the hospital in order to load it into the back of the van.